COVID-19 vaccination before or during pregnancy results in high, sustained maternal neutralizing activity to SARS-CoV-2 wild-type and Delta/Omicron variants of concern, particularly following a booster dose or infection.

Autor:	Mahyuddin AP; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Swa HLF; Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore., Weng R; Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore., Zhang J; Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore., Dhanaraj JP; Diagnostics Development Hub, Agency for Science, Technology and Research, Singapore, Singapore., Sesurajan BP; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Rauff M; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore., Dashraath P; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore., Kanneganti A; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore., Lee R; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore., Wang LF; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore; The Programme for Research in Epidemic Preparedness and Response (PREPARE), National Centre for Infectious Diseases, Singapore, Singapore., Young BE; The Programme for Research in Epidemic Preparedness and Response (PREPARE), National Centre for Infectious Diseases, Singapore, Singapore; National Centre for Infectious Diseases, Singapore, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tambyah PA; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore., Lye DC; The Programme for Research in Epidemic Preparedness and Response (PREPARE), National Centre for Infectious Diseases, Singapore, Singapore; National Centre for Infectious Diseases, Singapore, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Chai LYA; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore., Yee S; Innovation and Enterprise, Agency for Science, Technology and Research, Connexis North Tower, Singapore, Singapore., Choolani M; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore., Mattar CNZ; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, National University Health System, Singapore, Singapore. Electronic address: citramattar@nus.edu.sg.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2024 Sep; Vol. 146, pp. 107121. Date of Electronic Publication: 2024 May 31.
DOI:	10.1016/j.ijid.2024.107121
Abstrakt:	Objectives: To investigate multi-dose and timings of COVID-19 vaccines in preventing antenatal infection. Design: Prospective observational study investigating primary vaccinations, boosters, antenatal COVID-19 infections, neutralizing antibody (Nab) durability, and cross-reactivity to Delta and Omicron variants of concern (VOCs). Results: Ninety-eight patients completed primary vaccination prepregnancy (29.6%) and antenatally (63.3%), 24.2% of whom had antenatal COVID-19, while 7.1% were unvaccinated (28.6% had antenatal COVID-19). None had severe COVID-19. Prepregnancy vaccination resulted in vaccination-to-infection delay of 23.3 weeks, which extended to 45.2 weeks with a booster, compared to 16.9 weeks following antenatal vaccination (P < 0.001). Infections occurred at 26.2 weeks gestation in women vaccinated prepregnancy compared to 36.2 weeks gestation in those vaccinated during pregnancy (P < 0.007). The risk of COVID-19 infection was higher without antenatal vaccination (hazard ratio [HR] 14.6, P = 0.05) and after prepregnancy vaccination without a booster (HR 10.4, P = 0.002). Antenatal vaccinations initially led to high Nab levels, with mild waning but subsequent rebound. Significant Nab enhancement occurred with a third-trimester booster. Maternal-neonatal Nab transfer was efficient (transfer ratio >1), and cross-reactivity to VOCs was observed. Conclusion: Completing vaccination during any trimester delays COVID-19 infection and maintains effective neutralizing activity throughout pregnancy, with robust cross-reactivity to VOCs and efficient maternal-neonatal transfer. Competing Interests: Declarations of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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